Cochrane News

We encounter Evidence Syntheses on an almost day-to-day basis, but do we know what it is and why we need it?

Cochrane Ireland and Evidence Synthesis Ireland aims to build knowledge, awareness, and capacity in the methods used to gather and build evidence (known as evidence synthesis) and using it effectively to inform health and healthcare decisions in Ireland. Policy makers, healthcare institutions, clinicians, researchers and the public will stand to benefit.

Evidence synthesis, also sometimes called “systematic reviews”, is a way of combining information from multiple studies that have investigated the same thing, to come to an overall understanding of what they found. This helps determine how effective a certain treatment or drug is, or how people have experienced a particular health condition or treatment.

Among the dozens of Cochrane Reviews of various treatments for people with HIV or AIDS, are some that look more at how the treatments should be used, rather than the treatments themselves. One of these examines the timing of the start of treatment, and it was published in June 2019. Lead author, Alberto Mateo from the Liverpool School of Tropical Medicine in the UK, tells us about the evidence base and the findings for this important question.

"When people are diagnosed with HIV, they normally have to attend several clinic visits before they are offered treatment. This is to make sure that they are ready and that it is safe to start the medication. However, attending many clinic visits may be a barrier for people, particularly in low- and middle-income countries, which means that many of them stop being engaged with health services and never actually start the treatment. This makes them at risk of dying sooner than people on the therapy.

One proposed solution is to offer the antiretroviral therapy, or ART, on the same day that the person is diagnosed, or within a few days, what is known as “rapid ART”. We wanted to investigate if doing this could reduce mortality and improve other outcomes, and our review has found that rapid ART probably does increase the number of people initiating the therapy and the number of people with no detectable level of virus in the blood 12 months after diagnosis. We also found that rapid ART may increase the number of people in contact with healthcare services.

However, the evidence currently available does not allow us to say whether rapid ART reduces mortality. Some authors have previously suggested that giving ART so quickly after diagnosis could increase the number of drug adverse effects, and we did not have enough data to analyse this either.

It is important to note that in all the studies included in our review, rapid ART was delivered alongside several other interventions which needed to be in place to make rapid ART possible. These interventions allowed healthcare services to diagnose and assess the physical and psychological health of people with HIV to see if they were ready to start ART.

Looking forward, we hope that future studies will help to consolidate these promising findings, as well as determining which interventions help best to deliver rapid ART.”

Cochrane Chile is thrilled to present highlights of this year’s Scientific Program! Cochrane’s annual flagship event brings together hundreds of clinicians, health professionals, policy makers, researchers, patients, consumers and others to discuss and learn about the wide usage of Cochrane evidence in health decision-making at all levels. This year’s Colloquium will take place 22-25 October, with the theme “Embracing diversity”. Pre-Colloquium activities start October 20.

Nine Special Sessions, two presented in Spanish, will highlight innovative and interesting topics, varying from advances in the new Cochrane Handbook to multiple sessions on aspects of linguistic diversity in Cochrane; from engaging healthcare consumers in evidence, to technological innovation integrated with the evidence ecosystem.

Concurrent sessions will offer 63 workshops ranging across 18 topic categories. For the first time, 8 workshops will be presented in Spanish!

Fifty one oral presentation sessions will include 241 presentations and three poster sessions will comprise 242 posters, covering topics from 17 different categories. Posters and orals are presented by delegates from all over the world.

We are so excited to welcome you to Santiago! There is still time to register before the Standard Registration deadline.

A recent study comparing low back pain systematic reviews abstracts to their full text was published in the Journal of Orthopaedic & Sports Physical Therapy. Looking at 66 systematic reviews reserchers found that 80% of abstracts presented spin and inconsistencies when compared to their full text. 9 of the systematic reviews investigated were Cochrane Reviews and it was found that "Cochrane review abstracts had substantial to almost perfect agreement with the full text."

Lower back pain reviews are overseen by Cochrane Back and Neck (CBN). CBN coordinates the publication of literature reviews of diagnosis, primary and secondary prevention and treatment of neck and back pain and other spinal disorders, excluding inflammatory diseases and fractures. CBN is hosted by the Institute for Work & Health (IWH) in Toronto, Canada. IWH is an independent, not-for-profit organization. Its mission is to conduct and share research that protects and improves the health of working people and is valued by policy-makers, workers, workplaces, clinicians, and health & safety professionals.

The Cochrane geographic Centre is a leading national umbrella institution for evidence-based healthcare and guideline development, inclusive of a JBI Centre of Excellence, a Guidelines International Network member and the Masaryk University GRADE Centre.

The Centre was selected after a competitive application process that saw organizations from around the world contest to host the Global Evidence Summit in 2021. Professor Andrea Pokorná, Deputy Director of the Czech National Centre for Evidence-Based Healthcare and Knowledge Translation, is delighted that the Centre will host the Summit:

“Winning the bid to host is a great achievement that will influence the provision of healthcare in Central Europe, particularly in the Czech Republic. I am very proud that Masaryk University and its Centre for Evidence-based Healthcare and Knowledge Translation will be host to the Summit in 2021.”

The Global Evidence Summit 2021 will be held in October at O2 Universum, the brand new Multifunctional Cultural and Congress Centre in beautiful historic Prague and is easily accessible from every city quarter. Prague is home to one of the most complete ensembles of Renaissance, Gothic and Baroque architecture in Europe.

Director of Cochrane Czech Republic and the Czech National Centre for Evidence-Based Healthcare and Knowledge Translation, Dr Miloslav Klugar, said that by partnering to deliver the Global Evidence Summit the four organizing partners send a message that co-operation and knowledge sharing must be embraced to improve health and the quality of life for people globally: “The Global Evidence Summit 2021 is an exciting opportunity for us here in the Czech Republic, Central Europe and everyone around the world to create synergies and to benefit from knowledge sharing in the global evidence community.”

Deputy Director, Dr Jitka Klugarová, added, “We are very proud that the Global Evidence Summit 2021 will take place in the Czech Republic. It is an amazing opportunity for global stakeholders in healthcare, research, social justice and education to participate in a global discussion about evidence-based practice.”

The GES is a quadrennial event that brings together some of the world’s leading organizations in evidence-based practice in a shared mission to provide a platform to discuss critical issues across different sectors, including health, education, social justice, the environment and climate change. The GES is intended as a multi-disciplinary and cross-cultural event to exchange ideas about how we best produce, summarize and disseminate evidence to inform policy and practice, and using that evidence to improve people’s lives across the world.

Together with the host, the Czech National Centre for Evidence-Based Healthcare and Knowledge Translation, Cochrane, JBI, Campbell Collaboration, and Guidelines International Network intend the second Global Evidence Summit to build on the successes of the 2017 Summit in Cape Town to advance the use of reliable research evidence in addressing some of the world’s most serious health and social challenges.

In 2015 Cochrane published a review on this topic, which has now been updated to include six new trials, additional data from included trials, and addresses comments and criticisms.

Global Advocacy organisations claim routine deworming of all school children at regular intervals with deworming drugs in areas where helminth infection is common has substantive health and societal effects beyond the removal of worms.

This interview with David Taylor Robinson, Professor of Public Health and Policy, Honorary Consultant in Child Public Health at The University of Liverpool, tells us a little more about this review.

What is deworming and why is it important?Soil-transmitted worms, including roundworms, hookworms, and whipworms, are common in tropical and subtropical areas, and particularly affect children living in poverty where there is inadequate sanitation. The World Health Organization (WHO) currently recommends that school children in many areas are regularly treated with drugs which kill these worms. Some advocates claim such programmes improve child growth, haemoglobin, cognition, school attendance, school performance, physical fitness, and survival.

What is the history of this Cochrane Review?A summary is given here in this Cochrane editorial which gives some of the background to this debated area. Advocates believe strongly in population wide treatment programmes but the Cochrane review finds quite substantial evidence of no benefit in terms of haemoglobin, cognition, school performance, and mortality.

How widely is periodic deworming for children living in endemic areas advocated?Periodic deworming for children living in endemic areas has been advocated by organizations as influential as the World Health Organization, the World Bank, and the Bill & Melinda Gates Foundation, and it has been considered to be a fundamental solution to the problems associated with endemic soil‐transmitted helminth infections.

What did this update aim to do?To summarize the effects of public health programmes to regularly treat all children with deworming drugs on child growth, haemoglobin, cognition, school attendance, school performance, physical fitness, and mortality.

The evidence of no effect presented in the 2015 Cochrane Review was firm. Is this still the case with the 2019 review?Yes, the overall conclusions are the same. We have included data from six additional trials in the update and have addressed comments and criticisms following the 2015 version – as with the 2015 version we see substantial evidence of no benefit for haemoglobin, cognition, school performance, and mortality. For weight studies conducted in two settings over 20 years ago showed large effects on weight, but this hasn’t been shown in more recent larger studies.

Tell us more about how this update was conducted?Cochrane researchers examined the effects of deworming children in areas where intestinal worm infection is common. After searching for relevant trials up to 19 September 2018, we included 50 trials with a total of 84,336 participants, and an additional trial of one million children.

It includes randomised controlled trials (RCTs) and quasi-RCTs that compared deworming drugs for soil-transmitted helminths (STH) with placebo or no treatment in children aged 16 years or less, reporting on weight, height, haemoglobin, and formal tests of cognition. We also sought data on other measures of growth, school attendance, school performance, physical fitness, and mortality.

What does the 2019 Cochrane Review tell us?In populations of children living in endemic areas, the effect of the first, single dose of deworming drugs on weight is unclear. There was little or no effect in most studies, except for a large effect detected from one study area in Kenya, reported in two trials carried out over 30 years ago in a school where children were heavily infected with worms. This causes uncertainty which means we do not know if a first dose or single dose of deworming impacts on weight. For height, most studies showed little or no effect, with the exception of the site in Kenya. A single dose of deworming medicine probably has no effect on haemoglobin and cognition. There is insufficient data to know if there is an effect on school attendance, school performance, or physical fitness or mortality.

In studies where children were regularly treated with deworming medicine there was little or no effect on weight in all but two trials, irrespective of whether children were heavily infected with worms or not. The two trials with large average weight gains included the Kenya study carried out over 30 years ago, and one study from India carried out over 20 years ago in a low worm burden area where later studies in the same area did not show an effect. In trials from 2000 onwards, which are more relevant given the global reduction in worm burden, there is little or no effect. This causes uncertainty and means we do not know if regularly treating children with deworming medicine improves their weight. Regularly deworming children probably has no effect on height, haemoglobin, cognition, and mortality. We do not know if there is an impact on school attendance, since the evidence is inconsistent and at high risk of bias. There is insufficient data to know if there is an effect on physical fitness.

What criticism or comments does it address?We addressed some detailed comments from deworming advocates which were helpful, and we included some new studies as a result of this. Also, previous criticisms concerned splitting the analysis between people known to be infected and community studies where whole populations are treated. In this update we conducted a fresh analysis considering all the data together, stratified on the basis of worm burden. We also repeated the analysis for different worm types.

What message does this review have for policy makers and those delivering public health programmes?For public health programmes to regularly treat all children in endemic areas with deworming drugs, there is quite substantial evidence of no benefit in terms of haemoglobin, cognition, school performance, and mortality. For weight, contemporary studies do not show an effect, but unusually large effects were seen in studies over 20 years ago. We would caution against selecting only the evidence from these older studies as a rationale for contemporary mass treatment programmes.

What do you hope might happen as a result of this evidence update?We suggest that the current evidence does not support large public health programmes of deworming in low and middle- income countries. Countries implementing such programmes should consider the findings of our updated review and make their own minds up. People developing global guidelines should be clear on what basis deworming programmes are being promoted.

This role is an exciting opportunity to use your experience as a Publishing Technology Manager to make a difference in the field of health care research.

The Publishing Technology Manager will join Cochrane’s product team to oversee the management and development of the external publishing technology systems and vendors, including the editorial management system and production system.

The Publishing Technology Manager will work with the technology vendors, the Product Lead, Head of Review Production and Senior Editor (Publishing Operations) to ensure that Cochrane content is processed on time and to the desired specifications, and that any necessary development work or dependencies for new content types or workflows are captured and resolved.

We are looking for a self-motivated and highly organised individual who is able to work effectively and collaboratively with a diverse range of contacts across the world. The successful candidate will also have:

Educated to degree-level (or equivalent experience).

Experience of production systems, typesetters and paginators within scientific publishing.

Experience with web-based submission systems.

Fluent in English (written and spoken).

Excellent written and verbal communication skills.

Proven ability to establish and maintain positive relationships with people and teams from a range of

functional, professional, linguistic and cultural backgrounds.

Demonstrable experience of holding people to account.

Exceptional organisation skills and the ability to manage multiple projects at once.

Theoretical and practical experience of change management.

An understanding of how technology is affecting innovation within STM journal production and operations.

Cochrane is a global, independent network of health practitioners, researchers, patient advocates and others, responding to the challenge of making vast amounts of research evidence useful for informing decisions about health. We do this by synthesizing research findings to produce the best available evidence on what can work, what might harm and where more research is needed. Our work is recognised as the international gold standard for high quality, trusted information.

If you would like to apply for this position, please send a CV along with a supporting statement to recruitment@cochrane.org with “Publishing Technology Manager” in the subject line. The supporting statement should indicate why you are applying for the post, and how far you meet the requirements for the post outlined in the job description using specific examples. List your experience, achievements, knowledge, personal qualities, and skills which you feel are relevant to the post.

This role is an exciting opportunity to use your experience as a Senior Editorial Officer to make a difference in the field of health care research.

The Senior Editorial Officer will support the Editor in Chief of Cochrane in achieving the strategic aims and delivering the objectives of the Cochrane Editorial and Methods Department (EMD).

The Senior Editorial Officer will lead and oversee strategic projects, including:

Working with the Editorial and Communications Officer on strategic projects or programmes of works relevant to the strategic vision for Cochrane’s content and review production.

Supporting effective and timely communications between the Editorial and Methods Department and other departments of the Cochrane Executive Team.

Lead the development of editorial projects and plans for making Cochrane reviews more accessible (in liaison with the KT Department and IRD).

Working with the Peoples Services Department on projects aiming to improve authors’ experiences. This includes the delivery of Editorial and Author Charters describing agreed expectations between Networks, authors and CRGs to assure the equity and consistently high quality of the review process.

Supporting the Head of Review Production on operational projects relevant to the Cochrane Review Group (CRG) Networks including:

The implementation of the new Editorial Management System;

The development of Centralised Editorial Services;

The introduction of a new journal submission process; and

Editorial policy and process implementation.

We are looking for a self-motivated and highly organised individual who is able to work effectively and collaboratively with a diverse range of contacts across the world. The successful candidate will also have:

An understanding of the importance of systematic reviews to clinical decision-making.

An ability to work alongside varied teams in different cultural and linguistic settings.

Strong organization and prioritization skills

Attention to detail

Excellent written and verbal communication skills

Impressive interpersonal skills both in person and by telephone and Skype.

An ability to accomplish projects with little supervision.

Intermediate-level IT skills, including proficiency in Word, Excel and PowerPoint.

An ability to develop and maintain good working relationships with key stakeholders.

Knowledge of and commitment to Cochrane’s mission and values and good understanding of Cochrane’s Strategy 2020 goals and targets.

Cochrane is a global, independent network of health practitioners, researchers, patient advocates and others, responding to the challenge of making vast amounts of research evidence useful for informing decisions about health. We do this by synthesizing research findings to produce the best available evidence on what can work, what might harm and where more research is needed. Our work is recognised as the international gold standard for high quality, trusted information.

If you would like to apply for this position, please send a CV along with a supporting statement to recruitment@cochrane.org with “Senior Editorial Officer” in the subject line. The supporting statement should indicate why you are applying for the post, and how far you meet the requirements for the post outlined in the job description using specific examples. List your experience, achievements, knowledge, personal qualities, and skills which you feel are relevant to the post.

September is Polycystic Ovary Syndrome Awareness Month and is an excellent time to focus on the latest Cochrane evidence.

Polycystic ovary syndrome (PCOS) is a very common condition affecting 8% to 13% of women. Being overweight worsens all clinical features of PCOS. These clinical features include reproductive issues such as reduced frequency of ovulation and irregular menstrual cycles, reduced fertility, polycystic ovaries on ultrasound and high levels of male hormones such as testosterone, which can cause unwanted facial or body hair growth and acne. PCOS is also associated with metabolic features, with risk factors for diabetes and cardiovascular disease including high levels of insulin or insulin resistance and abnormal cholesterol levels. PCOS affects quality of life and can worsen anxiety and depression either due to its symptoms or due to the diagnosis of a chronic disease.

The Cochrane Gynaecology and Fertility Group (CGF) is concerned with the systematic evaluation of the management and treatment of menstrual disorders and subfertility. The CGF carries out extensive searches for all relevant randomised controlled trials (RCTs) both published and unpublished; scrutinises each trial for its relevance and quality; critically appraises trials; draws conclusions based on pooling data about how their net result should be applied in healthcare; and produces structured reports (systematic reviews) for widespread dissemination to health care providers and planners, and to consumers.

Here is a curated list of some PCOS related Cochrane systematic reviews:

We are looking for content creators who would like to help share the work of Cochrane and extend our annual scientific conference materials and discussion beyond attendees to their social media followers.

Cochrane Chile is hosting Cochrane’s Colloquium in Santiago, October 22-25, 2019. Cochrane’s Colloquium is an annual, global health event based on promoting the most prestigious evidence in the world and where hundreds of international researchers, opinion leaders, health experts and patients join together for open, scientific debate promoting the use of evidence in health. Through talks, workshops and other activities and presentations, we will be exploring this year's theme of “Embracing diversity”.

You can find Cochrane on Twitter, Facebook, YouTube, and Instagram. We want to open up the discussion and learning that will be had at our event to everyone who wants to be involved, not just attendees and not just our regular followers. By working with others on social media, we hope to explore some of the key conference themes and highlight the work of Cochrane to new audiences' including patients, health practitioners, policy-makers, guideline developers, health and science journalists and researchers.

What we are looking for:

Availability between October 22-25 Although it fine to post before and after these dates, Cochrane's Colloquium is being held in Santiago between these dates so we would need you to support this imitative during this time.

Creators of content in any language but we are particularly interested in working with English and Spanish creators.

Any social media platform - we are looking for pod-casters, bloggers, tweeters, Instagramers! Specialize in one or have many!

Have an audience interested in health or evidence-based medicine Your audience may be interested in one specific clinical area or health issue or have a more general interest .

Your own voice, your own opinions: We would like you to write in your style and share content that suits your audience. You are welcome to share your opinion on Cochrane or the topics being discussed but it's important that it is clear you are giving your own opinion and not 'speaking for Cochrane'. Please see our Spokesperson Policy.

Share evidence, not clinical recommendations: Communications about Cochrane evidence should present the evidence accurately and not make clinical recommendations. However, if you would like to comment on the evidence from your personal/professional experience or on Cochrane, for example for blogs or podcasts, please make it explicit that they are your own opinions. Please see our Spokesperson Policy.

People who respond to comments and encourage discussion. Discussion and debate is great! However we don't encourage responding to abusive comments or comments not relevant to matter under discussion. If individuals would like to raise issues with Cochrane outside of the scope of the social media conversation or have questions that would be better answered by Cochrane, please direct individuals to our 'Contact Us' page.

A respectful voice and moderator. All posts and responses should be polite and respect of others' views; even if you don't agree.

If you are selected, we will provide you with:

Graphics - Social media graphics you may use.

Pictures - of the Colloquium after each day.

Suggested content - tweets, content, and discussion points that you can adapt for your own accounts.

Hashtags - Suggested hashtags to increase traffic to your content. We have specific hashtags for different events at the conference that we will be encouraging people to use.

A shout-out - A profile in a news item on Cochrane.org that links out to your social media accounts; great for increasing your audience but also identifying others you may wish to collaborate with.

If you are attending the Colloquium, you'll also get:

Social Media VIP ribbon Wear your special ribbon on your name badge so that you are easily identifiable.

Social Media VIP Area A special area to meet-up at breaks with working space and a place to charge your devices.

Networking with others doing social media A networking event on Tuesday to kick-off the Colloquium and meet future collaborators.

Specifications: Full Time Salary: £23,000Location: London ApplicationClosing Date: 12th September 2019

This role is an exciting opportunity to use your experience in office administration to make a difference in the field of health care research.

The Office Administrator will provide effective and efficient administrative support to the EA to the CEO, to ensure smooth running of the London office and administrative functions for the Central Executive Team (CET).

We are looking for a self-motivated and highly organised individual who is able to work effectively and collaboratively with a diverse range of contacts across the world. If you have experience in a similar role within a government, charity, regulatory, or similar environment; excellent administrative skills; strong communication and interpersonal skills and a ‘can-do’ attitude then we would like to hear from you. In return, we can offer you a stimulating, highly collegiate, work environment with plenty of scope to make your own mark.

The successful candidate will also have:

Essential:

Previous experience of providing administrative support to a team

Intermediate level IT skills, including Word, Excel and PowerPoint

Strong organization and prioritization skills

Excellent written and verbal communication skills

Excellent interpersonal skills

Professional telephone manner

Ability to work methodically and accurately

A flexible approach with the ability to respond quickly to issues as they arise

A pro-active approach to problem-solving

Awareness of handling confidential and sensitive information

Preferred:

Experience of healthcare charity sector

Previous experience of providing PA support

Cochrane is a global, independent network of health practitioners, researchers, patient advocates and others, responding to the challenge of making vast amounts of research evidence useful for informing decisions about health. We do this by synthesizing research findings to produce the best available evidence on what can work, what might harm and where more research is needed. Our work is recognised as the international gold standard for high quality, trusted information.

If you would like to apply for this position, please send a CV along with a supporting statement to recruitment@cochrane.org with Office Administrator in the subject line. The supporting statement should indicate why you are applying for the post, and how far you meet the requirements for the post outlined in the job description using specific examples. List your experience, achievements, knowledge, personal qualities, and skills which you feel are relevant to the post.

The Skeptics’ Guide to Emergency Medicine (SGEM) is a podcast with over 40,000 subscribers and is translated into four other languages. It is open access with the goal of providing the most valid, reliable, and unbiased global source of currently clinically-relevant patient-centered emergency medicine information.

Cochrane is for anyone interested in using high-quality information to make health decisions. Whether you are a doctor or nurse, patient or carer, researcher or funder, Cochrane evidence provides a powerful tool to enhance your healthcare knowledge and decision making.

Cochrane’s 11,000 members and over 68,000 supporters come from more than 130 countries, worldwide. Our volunteers and contributors are researchers, health professionals, patients, carers, and people passionate about improving health outcomes for everyone, everywhere. Our global independent network gathers and summarizes the best evidence from research to help you make informed choices about treatment and we have been doing this for 25 years.

We are looking for an exceptional professional to lead our Human Resources function within the People Services Department. Reporting to the Head of People Services, your role will involve:

working with other senior People Services team members to produce and implement a Cochrane People Strategy that complements Cochrane’s organizational Strategy;

Provision of first-class HR transactional services which are highly regarded by end users

If you are CIPD level 7 qualified; have led an HR function in a similar-sized organisation with a complex international footprint; are familiar with expert knowledge workers who are a mixture of employees, consultants and secondees, have a ‘can do’ attitude and are in sympathy with our organizational aims then we would like to hear from you. In return, we can offer you a stimulating, highly collegiate, work environment with plenty of scope to make your own mark.

Celebrating over 60 years, Cancer Council NSW is an independent, community funded not for profit with a purpose. What's our point of difference? We look at all aspects of cancer from research right through to support, with an aim to fund research of the highest scientific merit and value to the community that it serves and represents.

Based in our Woolloomooloo office, you will join our highly regarded Cancer Research Division (CRD), which provides expert, impartial evidence that influences the actions of Cancer Council NSW, policy makers, practitioners and the community to reduce the national and international impact of cancer.

Research Program

You will contribute to an exciting research program, which aims to determine which cancer control interventions and programs can most effectively and cost-effectively reduce the numbers of people dying from cancer.

This involves modelling cancer mortality rates and numbers of cancer deaths in Australia out to 2040 and the impacts of different cancer control strategies on these rates and numbers.

The initial project findings will be used to guide the process of policy prioritisation for Cancer Councils to support the efficient and effective use of cancer control programs in the prevention, early detection and treatment of cancer at a population level.

Specifically?

The key purpose of this 12mth contract (with potential to be extended) will be to undertake systematic and scoping reviews of the medical and scientific literature to produce evidence-based summaries for inputs for models and publications in peer-reviewed journals and/or scientific reports.

Specifications: Full Time Salary: £70,000Location: Flexible, though with a preference for London - basedApplicationClosing Date: Tuesday 17th September 2019

Cochrane is the world’s most respected producer of high-quality health evidence to inform decision-making by healthcare practitioners, patients and carers, researchers and policymakers. Our global independent network of over 11,000 members and 68,000 supporters analyze and summarize the best evidence from research and publish it in the Cochrane Library (www.cochranelibrary.com). Cochrane is passionate about improving health outcomes for everyone, everywhere by helping them to make informed choices about healthcare issues and we have been doing this for 25 years.

We are looking for someone with exceptional leadership skills and experience to join our Senior Management Team as Head of Governance & Strategy. This is a newly-created role leading a Unit that reports to the Chief Executive Officer, and we will look to you to:

Act as Company Secretary of The Cochrane Collaboration, ensuring that all the right support structures are in place to enable our Governing Board to meet its responsibilities and obligations;

Lead and oversee high-quality support to the Board, its Sub-Committees, the Cochrane Council and other governance bodies. This will include managing the meeting schedule and the development of agendas and supporting documentation;

Lead and support Cochrane’s review and impact of our current organizational Strategy to 2020 and the development of our new strategy from January 2021;

Coordinate and oversee development and implementation of project management norms and standards, including the Unit’s technical support to Cochrane Central Executive Team and Cochrane Group staff;

Ensure Cochrane develops a robust organizational and programme monitoring and evaluation (M&E) approach, framework and metrics to measure the success and impact of its present and future activities and outputs, and ensure these are communicated and implemented across the organization;

Coordinate our approach to Risk Management and lead on reporting organizational risks to the leadership team and our Governing Board.

If you have experience in a senior role within a government, charity, regulatory, or similar environment; excellent analytical skills; proven strategic planning, project management and organisational reporting skills and a ‘can-do’ attitude then we would like to hear from you. In return, we can offer you a stimulating, highly collegiate, work environment with plenty of scope to make your own mark.

The Cochrane Community Exhibition Stand has traditionally been a hub of activity and a gathering point for both members, staff, and for those new to Cochrane. Come chat to us, get your questions answered, and learn more about Cochrane!

Our annual event, the Cochrane Colloquium, brings together members of the community, staff, and newcomers to Cochrane. Amongst the wide range of workshops, activities, social events, and support we are offering, we would like to ensure that consumers, students, early career professionals, and first time Colloquium participants have easily identifiable people to ask questions to and the chance to learn about the wide a range of Cochrane activities. At breaks or at lunch, we invite you to visit the Cochrane Community Exhibition Stand and come chat with us!

At the stand you will see people wearing a purple Cochrane sash so that you know who to approach if you have questions. Those with sashes have attended multiple Cochrane Colloquia and have a good awareness of Cochrane and our work – they are there for you to ask questions, have a chat and to network with. See you at the Community Booth!

Name: John HiltonCountry: United KingdomLanguages: EnglishRole: EditorSocial Media:Twitter, InstagramI work in the Editorial and Methods Department in the Cochrane Central Executive. Ask me about the Cochrane Library!

Name: Miranda CumpstonCountry: AustraliaLanguages: EnglishRole: Handbook Editor, Cochrane Public Health EditorSocial media:TwitterI've been involved with Cochrane since 2003, primarily as a trainer for Cochrane authors and also as an editor. Recently I've been involved in editing the new edition of the Cochrane Handbook - ask me about the Handbook or about authoring a review.

Name: Muriah UmoquitCountry: CanadaLanguages: EnglishRole: Communications and Analytics Officer, Knowledge Translation DepartmentSocial Media: Twitter, Facebook, Instagram, LinkedInI oversee the many internal and external communication channels that Cochrane uses – from newsletters to Instagram. Lets chat about how you are sharing health evidence and how to best reach your intended audience.

Name: Robin FeatherstoneCountry: CanadaLanguages:EnglishRole: Information SpecialistSocial media: TwitterI’m an Information Specialist for the Editorial & Methods Department in the Central Executive. Ask me about Cochrane Library, CENTRAL, Cochrane Register of Studies, anything about searching methods to support Cochrane reviews, or about the role of Information Specialists in Cochrane.

Name: Sabrina KhamissaCountry: United KingdomLanguages: EnglishRole: Events and brand Support Officer, Knowledge Translation DepartmentI'm the Events and Brand Support Officer for Cochrane. I help Cochrane Group's host the Colloquia and Governance Meetings. I also provide marketing, communications and brand support to the community. This will be my first Colloqium! I can support attendees with general information about every aspect of the Colloquium and venue. I can also point you in the right direct for which group/person to speak to, if you need to make contact with some, need advice or want to find out more about a particular project.

More profiles of Cochrane Community members helping at the Colloquium Exhibition Stand to be added!

Cochrane’s Colloquium is our annual flagship event, which brings together Cochrane contributors and stakeholders from around the world to discuss Cochrane research, systematic review methods, important global health questions, and promoting evidence-informed health care. This year our 26th annual event will be hosted in Santiago, Chile on 22-25 October 2019.

One important and highly anticipated element of our Colloquium is our poster sessions. This is a great opportunity to browse the work of important studies and speak directly to some of the lead authors. Many collaborations, partnerships, and learning have happened from these sessions.

This year in Chile we have up to 300 posters being presented. Rows of posters with vast text is difficult for attendees to navigate efficiently. We are also aware that many of our attendees will not have English as their native language, making the poster session even harder to navigate.

We have teamed up with Mike Morrison from the Michigan State University. Applying his expertise on industrial-organizational psychology, Mike has created Cochrane branded #betterposter design to help facilitate information exchange at this year’s colloquium.

Below is a quick introduction to these new templates - there is also a longer version to watch that explains the background and demonstrates why the traditional format is ineffective! We understand these videos go quickly and that even with subtitles added in, it may be difficult for those that are not Native-English speakers to follow. Therefore we will be hosting an free webinar in the next month to go over the design and how to edit the templates to create your own poster.

We welcome poster presenters to try out this new format – we will be inviting both the presenters and viewers to participate in a larger evaluation study of these templates after the Colloquium.

The Senior Evidence Analyst provides deep technical knowledge and collaborates with academics and research professionals to support the research requirements for the work area. This includes actively leading and contributing to project activities, designing review protocols, undertaking critical aspects of research work including analysis and key findings. Collates research data, draws insights and analyses, reports information from the research undertaken and work with internal and external stakeholders.

The Senior Evidence Analyst will work with the manager and other staff within the SRHTA team to develop systematic reviews and Health Technology Assessments (HTAs) and conduct evidence reviews for HTAs including: development of search strategies, conducting literature searches, review and selection of citations, extraction of data, quality assessment and critical appraisal and writing of reports. Together with conducting work for NHMRC Health Evidence Advice and Methods Panel; conducting evidence reviews and developing protocols the successful incumbent will have strong interpersonal and communication skills to develop and maintain effective relationships with multiple project clients and key clients.

In January 2018, the FDA announced a pilot aimed at enhancing the transparency of the Agency's drug approval process and decisions. As part of the pilot, sponsors of up to nine drug applications to the FDA were asked, on a voluntary basis, if they would approve the public release of portions of the CSRs, which would be posted within an Action Package for the drug that also includes FDA application review files and letters. The parts of the CSRs made publicly available included information from the study report body, the protocol and amendments, and the statistical analysis plan for each study.

Karla Soares-Weiser, Editor-in-Chief of the Cochrane Library, and members of the Cochrane Clinical Study Report Working Group have submitted a response to this pilot, which is reproduced below as an open letter. The Cochrane Clinical Study Report Working Group is a recently announced, open group that aims to support and facilitate the increased use of CSRs in Cochrane Reviews.

The Clinical Study Report Working Group also invites, and welcomes, any sponsors or regulators who would like to reach out and initiate discussions with us to help facilitate CSR use in Cochrane Reviews. To date, only two published Cochrane Reviews have used CSRs (here and here) and overcoming challenges with access and terms of use will be key to increasing this number.

Covering note: The attached letter was posted on the Cochrane Methods website on 22 August 2019 (https://methods.cochrane.org/news/open-response-FDA-Clinical-Data-Summary-Report-Pilot) in response to the FDA’s invitation for public comment on the Clinical Data Summary Report Pilot program (Docket No. FDA-2019-N-2012 for the “New Drugs Regulatory Program Modernization: Improving Approval Package Documentation and Communication”). We, the undersigned, Editor-in-Chief of the Cochrane Library and members of the Cochrane Clinical Study Report Working Group, are formally submitting our letter as part of the public comment process. Institutional affiliations, for identification purposes, and competing interest statements were current as of 22 August 2019. Submitted by Ella Flemyng on 22 August 2019.

Background

Cochrane exists so that healthcare decisions get better. We produce high-quality, relevant, up-to-date systematic reviews and other synthesized research evidence to inform health decision making.

Many projects in the field, including a recent Cochrane Methods Innovation Funded project, have highlighted that journal article reporting of randomized controlled trials (RCTs) is often incomplete and can therefore bias results of systematic reviews. Clinical study reports (CSRs) are increasingly recognised as a source of RCT information that can enhance the value of systematic reviews as they are likely to be the most comprehensive and complete single source of information about a RCT, particularly when compared to a journal article. CSRs help systematic reviewers gain a more detailed picture of the methods, and results for under-reported outcomes from a trial, especially adverse effects.

Feedback on the Clinical Data Summary Report Pilot program

By the end of the FDA Clinical Data Summary Report Pilot, only one sponsor out of a potential nine opted-in and approved the release of this information (in February 2018).

The released Erleada CSR contains substantially more information than would be available via a journal article, which is of huge benefit for systematic reviewers; the methods are better described, there is more information about the intervention and co-interventions, and the results tables and descriptions of adverse events are relatively comprehensive.

Redactions in the Erleada CSR are relatively light, but perhaps some are still unnecessary. For example, at the bottom of page 31, information on storage and use of the drug could be important. Redacted participant IDs means information across different tables cannot be linked. However, even with redactions, there is a lot of useful information in the document that would be valuable for researchers and systematic reviewers.

In addition to releasing information from the main body of the CSR, the protocol and amendments, and the statistical analysis plan for each study, we ask the FDA to provide access to the appendices, such as the complete tables and line listings of adverse events. Members of our CSR Working Group have found these can provide additional valuable information for the assessment of benefit and risk of a treatment.

We would also like to comment that the information on the ‘Drug Approval Package: ERLEADA (apalutamide)’ page is clearly identified and therefore easy to use, including the CSR, protocol and statistical analysis plan information. However, any integrated review provided by the FDA should be in addition to the individual reviews and materials that are already made publicly available in the FDA Drug Approval Packages, and not replace them. The individual reviews and other documentation in the packages can be used for multiple purposes, including the assessment of the safety and efficacy of medicines and the synthesis of data in systematic reviews. Publicly available CSRs and the full FDA Drug Approval Package can thus complement each other, and neither is a substitute for each other. Whilst a CSR is necessary for transparency, providing both will enhance the ability to independently assess benefit and risk of medicines.

The Erleada CSR and action package does not appear to have clear copyright or reuse information. We assume that by making the CSRs publicly available that there are no restrictions on use and the data presented in the CSR can be used freely within Cochrane Reviews. We encourage the FDA to include positive statements about re-use of data for all available CSRs.

We urge the FDA to make CSRs publicly available

Given the benefits of using CSRs, Cochrane is exploring how more could be used within relevant Cochrane Reviews. Cochrane held a consultation meeting in May 2019 to identify practical ways forward to facilitate CSR use within Cochrane review teams and we are developing a strategy based on these recommendations (summary post and meeting report can be found here).

CSRs are a complete record of a trial. They contain essential information about the benefits and harms of medications, and about the credibility of that information. Independent researchers and systematic reviewers need to be able to access CSRs to verify the presented summary evidence from RCTs and assess how it was generated, and if necessary, to re-evaluate conclusions. Access to CSRs when compared with other sources of data (journal articles, registry records, etc.) reduces the potential for mistakes, misinterpretations, bias, evidence distortion, corruption and fraud.

We support and applaud the efforts by the FDA to improve the transparency, usability and accessibility of information used in the drug review process. We urge the FDA to make it a mandatory policy to publicly disclose CSRs, not a voluntary choice of the sponsors. We also urge all sponsors with CSRs for new, or previously approved, drugs or biologics to publicly release them to help facilitate their use in systematic reviews and health decisions.

Karla Soares-Weiser: Karla Soares-Weiser is a full-time employee of Cochrane and receives a salary.

Isabelle Boutron: Isabelle Boutron is Prof of Epidemiology at Université de Paris and receives a salary from université de Paris and Assistance Publique de Hôpitaux de Paris. She is a member of the Cochrane CSR Working Group.

Yuan Chi: Yuan Chi has no employment relationship with Cochrane and is a member of the CSR Working Group in Cochrane.

Kerry Dwan: Kerry Dwan is a full-time employee of Cochrane and receives a salary, and is a member of the CSR Working Group in Cochrane.

Ella Flemyng: Ella Flemyng is a full-time employee of Cochrane and receives a salary. She is leading a project in Cochrane that aims to assess how more clinical study reports could be used in Cochrane Reviews and is setting up an open CSR Working Group in Cochrane.

Kit Gilchrist: Kit Gilchrist is a full-time employee of Cochrane and receives a salary, and is a member of the CSR Working Group in Cochrane.

Marius Goldkuhle: Marius Goldkuhle is not employed by Cochrane. He is a member of Cochrane Haematological Malignancies and the CSR Working Group within Cochrane.

Toby Lasserson: Toby Lasserson is a full-time employee of Cochrane and receives a salary, and is a member of the CSR Working Group in Cochrane.

Carol Lefebvre: Carol Lefebvre serves Cochrane part-time as Lead Convenor, Cochrane Information Retrieval Methods Group but receives no salary. She is an independent information consultant and receives fees for consultancy and teaching in information retrieval for evidence synthesis. She is a member of the CSR Working Group in Cochrane.

Anne Littlewood: Anne Littlewood is a salaried employee of Cochrane Oral Health, the University of Manchester. She is a member of the Cochrane CSR Working Group.

Evan Mayo-Wilson: In the last three years, Evan Mayo-Wilson has received support from the Laura and John Arnold Foundation, Patient Centered Outcomes Research Institute, National Institutes of Health, US Food and Drug Administration, and Robert Wood Johnson Foundation. He has no other interests to declare. He is a member of the Cochrane CSR Working Group.

Lorri Puil: In the last three years, Lorri Puil has received support from the Canadian Institutes of Health Research, the British Columbia Ministry of Health via the Therapeutics Initiative, Faculty of Medicine, University of British Columbia, and a Michael Smith Foundation for Health Research Reach grant. She is also part of a research group receiving funding from the Australian National Health and Medical Research Council, and a member of the CSR Working Group in Cochrane.

Teo Quay: Teo Quay is a full-time employee of Cochrane Anaesthesia and Cochrane Emergency and Critical Care. She is a member of the CSR Working Group in Cochrane.

Tarang Sharma: Tarang Sharma is a full-time employee of Cochrane and receives a salary, and is a member of the CSR Working Group in Cochrane. She has previously undertaken research using CSRs as source documents for reviews.

Farhad Shokraneh: Farhad Shokraneh is a member of the Cochrane CSR Working Group. No other competing interests to declare.

Nicole Skoetz: Nicole Skoetz a member of the Cochrane CSR Working Group. No other competing interests to declare.

Lesley Stewart: Lesley Stewart is employed by the University of York and has no financial conflicts of interest. She advocates data sharing and has previously used data from CSRs in her research. She is a member of the Cochrane CSR Working Group.

Emma Thomson: Emma Thomson is a full-time employee of Cochrane and receives a salary, and is a member of the CSR Working Group in Cochrane.

Sheila Wallace: Sheila Wallace is a full-time employee of Cochrane Incontinence (employed via the Group’s host Newcastle University) and receives a salary, and is a member of the CSR Working Group in Cochrane. The single largest funder of Cochrane Incontinence is the National Institute for Health Research (NIHR). The views and opinions expressed herein are those of the signatory and do not necessarily reflect those of Newcastle University, the Systematic Reviews Programme, NIHR, NHS or the Department of Health.

Would you be less likely to buy a chocolate bar to eat if there were fewer different chocolate bars on display in the shop and more types of fruit instead? And would you eat fewer snacks from a bowl if you had to walk to the other side of the room to get your hands on them?

We found 24 studies in total: six looked at altering availability and 18 at proximity. These studies provided low-certainty evidence that reducing the number of options of a range of food could reduce the amount selected by 36% (three studies in 154 people) and the amount consumed by 17% (two studies in 150 people). We also found low-certainty evidence from 12 studies in 1098 people that placing food products further away from people could reduce how much they consume by 19%. These findings suggest that overconsumption may be reduced by changing our food environments to reduce the number of options available – such as reducing the range of unhealthy foods on restaurant menus or in vending machines – and move unhealthier products to less convenient locations, such as away from supermarket checkouts.

But some important uncertainties about these results remain, including what they could mean for altering our food environments to reduce overconsumption. For example, relatively few studies have been conducted, and of these, many are of poor quality. Especially few studies tested the effect of these changes in “real world” settings and over the long-term. Most were conducted in scientific laboratories over short time periods. We therefore lack confidence that similar effects would be seen in the environments that matter - supermarkets, shops, cafeterias and restaurants where people buy and eat food. This lack of real-world evidence is consistent with other Cochrane Reviews that look at changing aspects of food environments, such as portion size and nutritional labelling.

This reflects the difficulty public health researchers have in gaining access to real world environments. Most supermarkets and cafeterias are commercial operations that benefit from their products being purchased and consumed. Consequently, they have little incentive to partner with researchers who want to find out how to reduce or change that consumption. But things are slowly changing, as commercial partners understand that the health of their staff and customers is a societal good, or at least is vital to a sustainable business. Important evidence is beginning to emerge from research programmes worldwide that involve commercial partners and research teams focused on changing food environments to benefit population and planetary health, including in the Netherlands, Australia and the UK (with furtherexamples here.)